The University of the State of New York
THE STATE EDUCATION DEPARTMENT
Office of Vocational and Educational Services for Individuals with Disabilities
(VESID)
Strategic Evaluation Data Collection, Analysis and Reporting (SEDCAR)
One Commerce Plaza - Room 1613
Albany, NY 12234-0001

(To be used by Approved Private Schools for Students
with Disabilities located in New York State)
2005-2006

This form is to be completed by approved private schools
located in New York State that provide special education services to students
with disabilities pursuant to Article 81 of the Education Law (not including
Special Act School Districts). Please designate a local education agency (LEA)
from whom to receive IDEA funds for students with disabilities provided special
education services pursuant to Article 81 of the Education Law and send the
completed form to the address in the letterhead and to the designated LEA, by
March 3, 2005.

In order to receive a sub-allocation of IDEA funds for
2005-2006 for students with disabilities who are placed in your school by public
school districts, you must also complete a SEDCAR-1 form and send it to each
school district that placed students in your program as of December 1, 2004. The
SEDCAR-1 form is due to each school district by March 3, 2005.

Instructions:

The completed SEDCAR-2 form, with original signature, must
be received by the State Education Department at the above address by
March 3, 2005.

Submit a copy of this form to the LEA designated to
receive the IDEA flow-through funds for students with disabilities
provided special education services pursuant to Article 81. The amount of
funds you will receive will be based upon formulas prescribed in IDEA,
Sections 611 and 619.

Retain one copy (and supporting
documentation) in your school for reference and audit purposes. The
required retention period ends June 30, 2011.

If you have any questions about this
report, please call (518) 474-7965, or (518) 486-4734.

Section 1-Approved Private School Program
Information(Non-Special Act School District)

IMPORTANT NOTE: This form must be received by the State
Education Department and by the designated LEA, by March 3, 2005, in order
to receive IDEA flow-through sub-allocations for the 2005-2006 school year.

Please check (3 ) the
appropriate cell to indicate the status of the LEA designated by the Approved
Special Education Program in Section 3.

(3)

1)

Continuation - The LEA designated for 2005-2006 was also
designated for 2004-2005

2)

Revision - The LEA designated for 2005-2006 is different
than the LEA designated for 2004-2005

3)

Initial - This is the first year in which an LEA has been
designated by this approved special education program (ASEP)

Certification and Assurances

The local education agency (LEA) listed in Section 3 is
designated by this ASEP to be allocated additional IDEA Section 611 and Section
619 flow-through funds by the State Education Department, based on the December
1, 1998 count of students provided educational services pursuant to Article 81
of the Education Law, as reported to SED in the PD-2 report, adjusted by a
population and poverty factor, for appropriate sub-allocation to this ASEP. I
understand that the LEA designated in Section 3 will receive such additional
IDEA funds for the 2005-06 year, and will continue to receive IDEA allocations
for subsequent years, to be sub-allocated to this school, unless a revised form
is submitted to SED for the designation of another LEA for the 2006-07 school
year.

__________________________
Original Ink Signature

___________________
Date Signed

Chief Administrative
Officer
Must Sign and Date

__________________________________
Name of Chief Administrative Officer(Please Type or Print)